Individual provider Active NPI

Nina Marie Tioleco, M.D.

  • Child & Adolescent Psychiatry Physician
  • Orangeburg, NY
National Provider Identifier
1043531973
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
265965 Issued in NY
Practice address
2 1St Ave
Orangeburg, NY 10962-1106
Phone
(845) 292-0362
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 265965 NY
Child & Adolescent Psychiatry Physician 2084P0804X 265965 NY Primary

Addresses

Primary practice location

2 1St Ave
Orangeburg, NY 10962-1106

Mailing address

PO Box 5
Port Jervis, NY 12771-0005
Phone (917) 745-5335

Other practice location 1

323 W 96th St Ste 2
New York, NY 10025-6281
Phone (917) 745-5335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141212000244 NY Practitioner - Psychiatry 4082936562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Discovery Inc CurrentSince Jul 1, 2019 Accepting new patients
The Center for Discovery Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

606 Old Route 17
Monticello, NY 12701
Phone (845) 707-8400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1043531973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127710005",
            "telephone_number": "917-745-5335",
            "fax_number": "425-559-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 1ST AVE",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109621106",
            "telephone_number": "845-292-0362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 W 96th St Ste 2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100256281",
            "country_code": "US",
            "telephone_number": "917-745-5335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIOLECO",
        "first_name": "NINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "265965",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "265965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, NY

Sources for this page

Verify at the official NPI Registry.